Managing Foreign-body Injuries in Individuals with Diabetes: A Diagnostic Challenge

Abstract

Abstract Introduction: Diabetes often leads to diabetic foot infections, resulting in hospitalizations and amputations. Foreign-body (FB) injuries in diabetes present significant diagnostic challenges. This study aims to unravel the complexities of FB injuries, focusing on implications, diagnostic hurdles, and management strategies due to their association with delayed detection and complications. Methods: A retrospective analysis was performed on 28 patients who visited the Chellaram Diabetes Institute, Pune, between June 2014 and August 2021, with a history of FB injury. We collected their clinical, radiological, microbiological and biomedical data including clinical outcomes. Results: The study included 28 subjects (71.43% males, 28.57% females) with a mean age and duration of diabetes of 65.07 ± 7.26 and 17.89 ± 9.15 years respectively. Peripheral neuropathy was observed in 95.83% of subjects. Imaging was used in 21 subjects: X-ray (n = 21; 5 had FBs) and ultrasound (n = 13; 6 had FBs). FBs were retrieved in 18 cases, with imaging detecting them in 9 cases (X-ray only: 3, X-ray + USG: 2, USG only: 4). In 12 subjects, FBs were removed bedside as accidental findings. The most common FB was a stone (n = 9), followed by wooden splinters (n = 6) and thorns (n = 6). Removal procedures were performed on both hospitalized and nonhospitalized subjects, highlighting undiagnosed injuries. Conclusion: This study underscores the importance of radiological modalities in detecting FBs and assessing the extent of infection they cause, aiming to enhance future FB management.